Skip Navigation Links.
Collapse <span class="m110 colortj mt20 fontw700">Volume 12 (2024)</span>Volume 12 (2024)
Collapse <span class="m110 colortj mt20 fontw700">Volume 11 (2023)</span>Volume 11 (2023)
Collapse <span class="m110 colortj mt20 fontw700">Volume 10 (2022)</span>Volume 10 (2022)
Collapse <span class="m110 colortj mt20 fontw700">Volume 9 (2021)</span>Volume 9 (2021)
Collapse <span class="m110 colortj mt20 fontw700">Volume 8 (2020)</span>Volume 8 (2020)
Collapse <span class="m110 colortj mt20 fontw700">Volume 7 (2019)</span>Volume 7 (2019)
Collapse <span class="m110 colortj mt20 fontw700">Volume 6 (2018)</span>Volume 6 (2018)
Collapse <span class="m110 colortj mt20 fontw700">Volume 5 (2017)</span>Volume 5 (2017)
Collapse <span class="m110 colortj mt20 fontw700">Volume 4 (2016)</span>Volume 4 (2016)
Collapse <span class="m110 colortj mt20 fontw700">Volume 3 (2015)</span>Volume 3 (2015)
Collapse <span class="m110 colortj mt20 fontw700">Volume 2 (2014)</span>Volume 2 (2014)
Collapse <span class="m110 colortj mt20 fontw700">Volume 1 (2013)</span>Volume 1 (2013)
American Journal of Medical Case Reports. 2015, 3(5), 144-145
DOI: 10.12691/AJMCR-3-5-7
Original Research

Facial Herpes Simplex Virus Type 1 Infection in a Patient with Multiple Sclerosis on Fingolimod

Racosta Juan Manuel1, McEwan Lynn1, Kremenchutzky Marcelo Carlos1 and Morrow Sarah Anne1,

1University of Western Ontario, London, Ontario

Pub. Date: April 23, 2015

Cite this paper

Racosta Juan Manuel, McEwan Lynn, Kremenchutzky Marcelo Carlos and Morrow Sarah Anne. Facial Herpes Simplex Virus Type 1 Infection in a Patient with Multiple Sclerosis on Fingolimod. American Journal of Medical Case Reports. 2015; 3(5):144-145. doi: 10.12691/AJMCR-3-5-7

Abstract

Fingolimod is an oral disease-modifying therapy for relapsing multiple sclerosis widely used in Canada as a second-line therapy. Fingolimod increases the risk of infections given its dose-dependent reduction of peripheral lymphocytes, due to the reversible sequestration in lymphoid tissues. We present a case of disseminated facial Herpes Simplex Virus type I infection in a patient using fingolimod, with an atypical distribution of the eruption, likely due to the concomitant exposure to sunlight and application of sunscreen. This case report provides insight about a novel mechanism of disseminationof Herpes Simplex Virus type I, which generally enters damaged epithelium or mucosal surfaces secondary to abrasions or trauma. Since Herpes Simplex Virus type I infection tends to disseminate and is accompanied by visceral involvement in immunosuppressed patients, close surveillance of viral infections and the prompt administration of full-dose antiviral therapy in this population is advised.

Keywords

multiple sclerosis, fingolimod; herpes simplex, infection, adverse effect

Copyright

Creative CommonsThis work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References

[1]  Cohen J.A., Chun J. "Mechanisms of fingolimod's efficacy and adverse effects in multiple sclerosis", Annals of Neurology, 69(5).759-777. May. 2011.
 
[2]  Kappos L., Radue E.W., O'Connor P., Polman C., Hohlfeld R., Calabresi P., et al. "A placebo-controlled trial of oral fingolimod in relapsing multiple sclerosis", New England Journal of Medicine, 362(5).387-401. Feb.2010.
 
[3]  Calabresi P.A., Radue E.W., Goodin D., Jeffery D., Rammohan K.W., Reder A.T., et al. "Safety and efficacy of fingolimod in patients with relapsing-remitting multiple sclerosis (FREEDOMS II): A double-blind, randomised, placebo-controlled, phase 3 trial", Lancet Neurology, 13(6).545-556. Jun.2014.
 
[4]  Khatri B., Barkhof F., Comi G., Hartung H.P., Kappos L., Montalban X., et al. "Comparison of fingolimod with interferon beta-1a in relapsing-remitting multiple sclerosis: A randomised extension of the TRANSFORMS study",Lancet Neurology, 10(6).520-529.Jun.2011.
 
[5]  Maalouf E., Moutran R., Maatouk I. "Disseminated primary HSV-2 infection of the face",Dermatology Online Journal, 18(6).15. Jun.2012.
 
[6]  Brinkmann V., Chen S., Feng L., Pinschewer D., Nikolova Z., Hof R.. "FTY720 alters lymphocyte homing and protects allografts without inducing general immunosuppression", Transplantation Proceedings, 33(1-2).530-531. Feb-Mar. 2001.
 
[7]  Pinschewer D.D., Ochsenbein A.F., Odermatt B., Brinkmann V., Hengartner H., Zinkernagel R.M. "FTY720 immunosuppression impairs effector T cell peripheral homing without affecting induction, expansion, and memory",Journal of Immunology, 164(11).5761-70.Jun. 2000.